Piloting the Affordable Medicines Facility-malaria: what will success look like?
Gavin Yamey, Marco Schäferhoff & Dominic Montagu
Volume 90, Number 6, June 2012, 452-460
Table 3. Estimated benchmarks of success of programmes subsidizing artemisinin-based combination therapies at 1 and 2 years
|Year 1||Year 2|
|Price:a adult equivalent treatment dose||QAACT price < 300% of the price of the dominant non-QAACT (in most countries this is CQ or SP) AND price of AMFm co-paid QAACT < price of AMT (this is useful but not sufficient to determine success)||QAACT price < 150% of the price of the dominant non-QAACT (in most countries this is CQ or SP) AND price of AMFm co-paid QAACT < price of AMT (this is useful but not sufficient to determine success)|
|Availability: proportion of all facilities, private and public (including informal outlets), stocking QAACTs among outlets with any antimalarials in stock at the time of the survey||Increase of 20 percentage points from baseline||Increase of 40 percentage points from baseline|
|Market share: total volume of QAACTs sold or distributed as a proportion of the total volume of all antimalarials sold or distributed in the previous 7 days via outlets that will be included in the independent evaluation’s surveys||Increase in ACT market share of 10–15 percentage points from baseline AND decrease in market share of AMT from baseline||Increase in ACT market share of 15– 20 percentage points from baseline AND decrease in market share of AMT from baseline|
|Use:b proportion of children aged less than 5 years with fever who received a QAACT on the day that the fever started or on the following day||Increase of 5–10 percentage points from baseline||Increase of 10–15 percentage points from baseline|
ACT, artemisinin-based combination therapy; AMFm, Affordable Medicines Facility-malaria; AMT, artemisinin monotherapy; CQ, chloroquine; QAACT, quality-assured ACT (an ACT that has met the Global Fund’s quality assurance policy); SP: sulfadoxine-pyrimethamine
a Price change was the indicator with the weakest empirical basis for setting a 1-year expectation.
b The denominator for ACT use is “fever episodes in children aged less than 5 years” (not “parasitologically confirmed malaria cases”). The independent evaluation relies on national surveys (e.g. Demographic and Health Surveys; Multiple Indicator Cluster Surveys; Malaria Indicator Surveys; ACTwatch surveys) that use this denominator due to a lack of proper malaria diagnosis in many countries.